Serum albumin, inflammation, and nutrition in end‐stage renal disease: C‐reactive protein is needed for optimal assessment

Mukai, Hideyuki; Villafuerte, Hilda; Qureshi, Abdul Rashid; Lindholm, Bengt; Stenvinkel, Peter

doi:10.1111/sdi.12731

Cited by 39 publications

(29 citation statements)

References 56 publications

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“…Low serum albumin concentration is common in ESRD patients and is associated with faster disease progression [40]. In the current study, we observed seasonal variation in the concentration of albumin and prealbumin-we recorded a significantly lower albumin concentration in the PW period as compared with the PS period; the same applied to prealbumin (Figure 1).…”

Section: Acute Phase Proteins' Seasonal Variationsupporting

confidence: 61%

Acute Phase Proteins and Vitamin D Seasonal Variation in End-Stage Renal Disease Patients

Maraj

Hetwer

Dumnicka

et al. 2020

JCM

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End-stage renal disease (ESRD) patients are vulnerable to vitamin D deficiency due to impaired renal hydroxylation, low dietary intake and inadequate sun exposure. Vitamin D plays a role in innate and adaptive immunity and its seasonal variation has been linked to mortality. ESRD is associated with inadequate removal of pro-inflammatory cytokines regulating acute phase protein (APP) synthesis. Our aim was to look for associations between lifestyle factors, diet, and vitamin D seasonal variation and their relationship with selected APPs and calcium-phosphate metabolism. The study included 59 ESRD patients treated with maintenance hemodialysis. A 24-hour dietary recall was conducted in the post-summer (November 2018, PS) and post-winter (February/March 2019, PW) period, and blood was collected for the measurements of serum total vitamin D, α 1 -acid glycoprotein (AGP), C-reactive protein (CRP), albumin, prealbumin (PRE), parathormone, calcium and phosphate. A self-constructed questionnaire gathered information on vitamin D supplementation, sun exposure and physical activity. Higher caloric intake was observed PW compared PS. Less than 15% of participants met the dietary recommendations for energy, protein, fiber, vitamin D and magnesium intake. Vitamin D supplementation was associated with higher serum vitamin D regardless of season. AGP, PRE, albumin, and vitamin D presented seasonal changes (higher values PS). In patients with serum vitamin D below 25 ng/mL, vitamin D seasonal change correlated with CRP and prealbumin change. Phosphate and Ca × P correlated positively with AGP. A low vitamin D serum level could impact the inflammatory process; however, more studies are needed to confirm the relationship.

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Section: Acute Phase Proteins' Seasonal Variationsupporting

confidence: 61%

Acute Phase Proteins and Vitamin D Seasonal Variation in End-Stage Renal Disease Patients

Maraj

Hetwer

Dumnicka

et al. 2020

JCM

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“…The serum albumin level has been identified as a significant prognostic factor for patients with various types of cancer [ [16] , [17] , [18] ]. This reflects the important role of serum albumin as a biomarker of the visceral protein and immunocompetence status, which is fundamental for the biological nutritional assessment [ 19 ]. In the present case series, in-hospital mortality rate of the patients who had all 3 of these risk factors was 75%.…”

Section: Discussionmentioning

confidence: 99%

A retrospective analysis of emergency surgery for cases of acute abdomen during cancer chemotherapy. Case series

Maeda

Shinohara

Minagawa

et al. 2020

Annals of Medicine and Surgery

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Background Treatment for acute abdomen during chemotherapy is frequently difficult because of the complicated status of the patients, and there have been only a few case series summarizing the outcomes of emergent surgery during chemotherapy. The aim of this study was to clarify the clinical outcomes of emergency surgery for acute abdomen during chemotherapy and identify predictive factors associated with mortality. Methods We retrospectively analyzed the records of patients who underwent emergency surgery for acute abdomen within 30-days after anti-cancer drugs administration between 2009 and 2020. Results Thirty patients were identified. The primary malignancies were hematological (n = 7), colorectal (n = 4), lung (n = 4), stomach (n = 2), breast (n = 2), prostate (n = 2) and others (n = 5). Fifteen patients were treated with the regimen, including molecular-targeted anti-cancer drugs (Bevacizumab: 8 cases, Rituximab: 4, Ramucirumab: 2, and Gefitinib: 1). Indications for emergency surgery were perforation of the gastrointestinal tract (n = 24), appendicitis (n = 3), bowel obstruction (n = 2), and gallbladder perforation (n = 1). Severe morbidity (Clavien-Dindo IIIa or more) occurred in 8 cases (27%), and there were 6 in-hospital deaths (20%). Significant factors related to in-hospital death were age >70 years old (P = 0.029), poor performance status (ECOG score 1 or 2) (P = 0.0088), and serum albumin level <2.6 g/dl (P = 0.026). The incidence of acute abdomen (odds ratio 5.31, P = 0.00017) was significantly higher in the patients receiving anti-VEGF drugs than in those without anti-VEGF drugs. Conclusion This study identified three predictive factors associated with in-hospital death after emergency surgery during chemotherapy: an older age, poor performance status, and low serum albumin level.

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“…6 Numerous studies published in recent years have demonstrated that there is a close association between reduced levels of 25-OH-D and all-cause mortality, as well as with cardiovascular mortality in subjects with CKD, including incident and prevalent patients on HD and peritoneal dialysis, in whom inflammation is one of the main mechanisms underlying the condition. [7][8][9] Inflammation in patients on HD can be measured using C-reactive protein (CRP), ultrasensitive CRP (US-CRP), interleukin-6, tumor necrosis factor alpha, procalcitonin, albumin, ferritin and cholesterol. Of these markers, US-CRP quantification is the gold standard owing to its low cost and availability.…”

Section: Introductionmentioning

confidence: 99%

Association between vitamin D serum levels and inflammatory markers in patients on hemodialysis

Ledesma¹,

Moragrega²,

Castillón³

et al. 2023

GMM

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Introduction:The relationship between 25-OH-vitamin D and the immune system in patients with chronic kidney disease is a subject of attention. Objectives: To assess the prevalence of vitamin D deficiency in patients on hemodialysis and to investigate the association between vitamin D, ultra-sensitive C-reactive protein (US-CRP), neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR). Method: Cross-sectional study of 80 patients on hemodialysis, divided into two groups: a serum 25-OH-vitamin D level < 20 ng/mL was considered to be vitamin D deficiency and a serum level ≥ 20 ng/mL was regarded as normal. The relationship between the parameters was defined with Spearman's correlation analysis. Results: 40 % of the patients had vitamin D deficiency. There were significant differences between groups in US-CRP (p = 0.047), NLR (p = 0.039), PLR (p = 0.042) and treatment with vitamin D analogues (p = 0.022). Vitamin D had a significant negative correlation with US-CRP (p = 0.026), NLR (p = 0.013) and PLR (p = 0.022). Conclusions: The prevalence of vitamin D deficiency was 40 %. The values of US-CRP, NLR and PLR were significantly higher in the presence of vitamin D deficiency. A significant inverse correlation was found between vitamin D levels and US-CRP, NLR and PLR.

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Serum albumin, inflammation, and nutrition in end‐stage renal disease: C‐reactive protein is needed for optimal assessment

Cited by 39 publications

References 56 publications

Acute Phase Proteins and Vitamin D Seasonal Variation in End-Stage Renal Disease Patients

Acute Phase Proteins and Vitamin D Seasonal Variation in End-Stage Renal Disease Patients

A retrospective analysis of emergency surgery for cases of acute abdomen during cancer chemotherapy. Case series

Association between vitamin D serum levels and inflammatory markers in patients on hemodialysis

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